ArticleWorld journal of gastroenterology2016
Cost effectiveness of routine duodenal biopsies in iron deficiency anemia.
Article in World journal of gastroenterology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.
- Defining the optimum strategy for identifying adults and children with coeliac disease: systematic review and economic modelling.Health technology assessment (Winchester, England) · 2022Pooled it
- Systematic Literature Review of the Economic Burden of Celiac Disease.PharmacoEconomics · 2019Pooled it
- Ironing Out the Deficiency: Tracking Iron in Celiac Disease Before and After the Gluten-Free Diet.Nutrients · 2026Review
- Why Is There Medical Inertia and Nihilism to Celiac Disease? Comment on Pivetta et al. In Elderly Anemic Patients without Endoscopic Signs of Bleeding Are Duodenal Biopsies Always Necessary to Rule out Celiac Disease?Diagnostics (Basel, Switzerland) · 2022Article
- No Danger for Medical Interest and Awareness towards Celiac Disease. Reply to Greenaway et al. Why Is There Medical Inertia and Nihilism to Celiac Disease? Comment on "Pivetta et al. In Elderly Anemic Patients without Endoscopic Signs of Bleeding Are Duodenal Biopsies Always Necessary to Rule Out Celiac Disease?Diagnostics (Basel, Switzerland) · 2022Article
- In Elderly Anemic Patients without Endoscopic Signs of Bleeding Are Duodenal Biopsies Always Necessary to Rule Out Celiac Disease?Diagnostics (Basel, Switzerland) · 2022Article
- Value of routine duodenal mucosal biopsies in the evaluation of anemia in a large Australian referral centre.JGH open : an open access journal of gastroenterology and hepatology · 2018Article
- Physicians' attitude and perception regarding celiac disease: A questionnaire-based study.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2018Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimTo investigate the cost effectiveness of routine small bowel biopsies (SBBs) in patients with iron deficiency anemia (IDA) independent of their celiac disease (CD) serology test results.
methodsWe used a state transition Markov model. Two strategies were compared: routine SBBs during esophagogastroduodenoscopy (EGD) in all patients with IDA regardless their celiac serology status (strategy A) vs SBBs only in IDA patients with positive serology (strategy B). The main outcomes were quality adjusted life years (QALY), average cost and the incremental cost effectiveness ratio (ICER). One way sensitivity analysis was performed on all variables and two way sensitivity analysis on selected variables were done. In order to validate the results, a Monte Carlo simulation of 100 sample trials with 10, and an acceptability curve were performed.
resultsStrategy A of routine SBBs yielded 19.888 QALYs with a cost of $218.10 compared to 19.887 QALYs and $234.17 in strategy B. In terms of cost-effectiveness, strategy A was the dominant strategy, as long as the cost of SBBs stayed less than $67. In addition, the ICER of strategy A was preferable, providing the cost of biopsy stays under $77. Monte Carlo simulation demonstrated that strategy A yielded the same QALY but with lower costs than strategy B.
conclusionOur model suggests that EGD with routine SBBs is a cost-effective approach with improved QALYs in patients with IDA when the prevalence of CD is 5% or greater. SBBs should be a routine screening tool for CD among patients with IDA, regardless of their celiac antibody status.
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